Skip to main content
Top
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Study protocol

Safety during the monitoring of diabetic patients: trial teaching course on health professionals and diabetics - SEGUDIAB study

Authors: Juan J Cabré, Marta Ripoll, Josep M Hernández, Josep Basora, Ferran Bejarano, Victoria Arija

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Safety for diabetic patients means providing the most suitable treatment for each type of diabetic in order to improve monitoring and to prevent the adverse effects of drugs and complications arising from the disease. The aim of this study is to analyze the effect of imparting educational interventions to health professionals regarding the safety of patients with Diabetes Mellitus (DM).

Methods

Design: A cluster randomized trial with a control group.
Setting and sample: The study analyzed ten primary healthcare centres (PHC) covering approximately 150,000 inhabitants. Two groups of 5 PHC were selected on the basis of their geographic location (urban, semi-urban and rural), their socio-economic status and the size of their PHC, The interventions and control groups were assigned at random. The study uses computerized patient records to individually assess subjects aged 45 to 75 diagnosed with type 1 and type 2 DM, who met the inclusion conditions and who had the variables of particular interest to the study.
Trial: The educational interventions consisted of a standardized teaching course aimed at doctors and nurses. The course lasted 6 hours and was split into three 2-hour blocks with subsequent monthly refresher courses.
Measurement: For the health professionals, the study used the Diabetes Attitude Scale (DAS-3) to assess their attitudes and motivation when monitoring diabetes. For the patients, the study assessed factors related to their degree of control over the disease at onset, 6, 12 and 24 months.
Main variables: levels of HbA1c.
Analysis: The study analyzed the effect of the educational interventions both on the attitudes and motivations of health professionals and on the degree of control over the diabetes in both groups.

Discussion

Imparting educational interventions to health professionals would improve the monitoring of diabetic patients. The most effective model involves imparting the course to both doctors and nurses. However, these models have not been tested on our Spanish population within the framework of primary healthcare.

Trial registration

ClinicalTrials.gov: NCT01087541
Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization: World Alliance for patient safety. Forward Programme. 2004, Geneva World Health Organization: World Alliance for patient safety. Forward Programme. 2004, Geneva
2.
go back to reference Scherbaum WA, Ohmann C, Abholz HH, Dragano N, Lankisch M: Effect of the frequency of self-monitoring blood glucose in patients with type 2 diabetes treated with oral antidiabetic drugs - a multi-centre, randomized controlled trial. PLoS ONE. 2008, 3: e3087-10.1371/journal.pone.0003087.CrossRefPubMedPubMedCentral Scherbaum WA, Ohmann C, Abholz HH, Dragano N, Lankisch M: Effect of the frequency of self-monitoring blood glucose in patients with type 2 diabetes treated with oral antidiabetic drugs - a multi-centre, randomized controlled trial. PLoS ONE. 2008, 3: e3087-10.1371/journal.pone.0003087.CrossRefPubMedPubMedCentral
3.
go back to reference Farmer AJ, Wade AN, French DP, Simon J, Yudkin P, Gray A, Craven A, Goyder L, Holman RR, Mant D, Kinmonth AL, Neil HA, DiGEM Trial Group: Blood glucose self-monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess. 2009, 13: 1-50.CrossRef Farmer AJ, Wade AN, French DP, Simon J, Yudkin P, Gray A, Craven A, Goyder L, Holman RR, Mant D, Kinmonth AL, Neil HA, DiGEM Trial Group: Blood glucose self-monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess. 2009, 13: 1-50.CrossRef
4.
go back to reference Brownson CA, Hoerger TJ, Fisher EB, Kilpatrick KE: Cost-effectiveness of diabetes self-management programs in community primary care settings. Diabetes Educ. 2009, 35: 761-769. 10.1177/0145721709340931.CrossRefPubMed Brownson CA, Hoerger TJ, Fisher EB, Kilpatrick KE: Cost-effectiveness of diabetes self-management programs in community primary care settings. Diabetes Educ. 2009, 35: 761-769. 10.1177/0145721709340931.CrossRefPubMed
5.
go back to reference Funnell MM, Nwankwo R, Gillard ML, Anderson RM, Tang TS: Implementing an empowerment-based diabetes self-management education program. Diabetes Educ. 2005, 31: 53-61. 10.1177/0145721704273166.CrossRefPubMed Funnell MM, Nwankwo R, Gillard ML, Anderson RM, Tang TS: Implementing an empowerment-based diabetes self-management education program. Diabetes Educ. 2005, 31: 53-61. 10.1177/0145721704273166.CrossRefPubMed
6.
go back to reference Golay A, Lagger G, Chambouleyron M, Carrard I, Lasserre-Moutet A: Therapeutic education of diabetic patients. Diabetes Metab Res Rev. 2008, 24: 192-196. 10.1002/dmrr.798.CrossRefPubMed Golay A, Lagger G, Chambouleyron M, Carrard I, Lasserre-Moutet A: Therapeutic education of diabetic patients. Diabetes Metab Res Rev. 2008, 24: 192-196. 10.1002/dmrr.798.CrossRefPubMed
7.
go back to reference Maciá C, Monzon A, Fernándex E: Aspirin for the primary prevention of cardiovascular diseases in diabetic patients. A review of currently available tests. Revisión de las pruebas disponibles. Rev Esp Salud Pública. 2006, 80: 613-620. Maciá C, Monzon A, Fernándex E: Aspirin for the primary prevention of cardiovascular diseases in diabetic patients. A review of currently available tests. Revisión de las pruebas disponibles. Rev Esp Salud Pública. 2006, 80: 613-620.
8.
go back to reference Tomizawa A, Hattori Y, Suzuki K, Okayasu T, Kase H, Satoh H, Kasai K: Effects of statins on vascular endothelial function in hypercholesterolemic patients with type 2 diabetes mellitus: Fluvastatin vs. rosuvastatin. Int J Cardiol. 2009 Tomizawa A, Hattori Y, Suzuki K, Okayasu T, Kase H, Satoh H, Kasai K: Effects of statins on vascular endothelial function in hypercholesterolemic patients with type 2 diabetes mellitus: Fluvastatin vs. rosuvastatin. Int J Cardiol. 2009
9.
go back to reference Saha SA, Molnar J, Arora RR: Tissue angiotensin-converting enzyme inhibitors for the prevention of cardiovascular disease in patients with diabetes mellitus without left ventricular systolic dysfunction or clinical evidence of Heart failure: a pooled meta-analysis of randomized placebo-controlled clinical trials. Diabetes Obes Metab. 2008, 10: 41-52.PubMed Saha SA, Molnar J, Arora RR: Tissue angiotensin-converting enzyme inhibitors for the prevention of cardiovascular disease in patients with diabetes mellitus without left ventricular systolic dysfunction or clinical evidence of Heart failure: a pooled meta-analysis of randomized placebo-controlled clinical trials. Diabetes Obes Metab. 2008, 10: 41-52.PubMed
10.
go back to reference O'Connor PJ, Sperl-Hillen JM, Johnson PE, Rush WA: Identification, classification, and frequency of medical errors in outpatient diabetes care. Advances in patient safety: from research to implementation. Errors in Outpatient diabetes Care. Edited by: Henrikson K. 2007, Rockville, MD: Agency for Healthcare Research and Quality, 1: O'Connor PJ, Sperl-Hillen JM, Johnson PE, Rush WA: Identification, classification, and frequency of medical errors in outpatient diabetes care. Advances in patient safety: from research to implementation. Errors in Outpatient diabetes Care. Edited by: Henrikson K. 2007, Rockville, MD: Agency for Healthcare Research and Quality, 1:
11.
go back to reference Rodbard HW, Blonde L, Braithwaite SS, Brett EM, Cobin RH, Handelsman Y, Hellman R, Jellinger PS, Jovanovic LG, Levy P, Mechanick JI, Zangeneh F, AACE Diabetes Mellitus Clinical Practice Guidelines Task Force: American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007, 13 (Suppl 1): 1-68.CrossRefPubMed Rodbard HW, Blonde L, Braithwaite SS, Brett EM, Cobin RH, Handelsman Y, Hellman R, Jellinger PS, Jovanovic LG, Levy P, Mechanick JI, Zangeneh F, AACE Diabetes Mellitus Clinical Practice Guidelines Task Force: American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007, 13 (Suppl 1): 1-68.CrossRefPubMed
13.
go back to reference Standards of medical care in diabetes-2008. Diabetes Care. 2008, American Diabetes Association, 29 (Suppl 1): S4-42. Standards of medical care in diabetes-2008. Diabetes Care. 2008, American Diabetes Association, 29 (Suppl 1): S4-42.
14.
go back to reference Singh S, Loke YK, Furberg CD: Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis. JAMA. 2007, 298: 1189-1195. 10.1001/jama.298.10.1189.CrossRefPubMed Singh S, Loke YK, Furberg CD: Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis. JAMA. 2007, 298: 1189-1195. 10.1001/jama.298.10.1189.CrossRefPubMed
15.
16.
go back to reference Ashwell SG, Bradley C, Stephens JW, Witthaus E, Home PD: Treatment satisfaction and quality of life with insuline glargine plus insuline lispro compared with NPH insulin plus unmodified human insulin in individuals with type 1 diabetes. Diabetes Care. 2008, 31: 1112-1117. 10.2337/dc07-1183.CrossRefPubMed Ashwell SG, Bradley C, Stephens JW, Witthaus E, Home PD: Treatment satisfaction and quality of life with insuline glargine plus insuline lispro compared with NPH insulin plus unmodified human insulin in individuals with type 1 diabetes. Diabetes Care. 2008, 31: 1112-1117. 10.2337/dc07-1183.CrossRefPubMed
17.
go back to reference Parchman Michael, Pugh Jacqueline, Romero Raquel, Bowers Krista: Competing demands or clinical inertia: The case of elevated glycosylated hemoglobin. Ann Fam Med. 2007, 196-201. 5 Parchman Michael, Pugh Jacqueline, Romero Raquel, Bowers Krista: Competing demands or clinical inertia: The case of elevated glycosylated hemoglobin. Ann Fam Med. 2007, 196-201. 5
18.
go back to reference Julie NL, Julie IM, Kende AI, Wilson GL: Mitochondrial dysfunction and delayed hepatotoxicity: another lesson from troglitazone. Diabetologia. 2008, 51: 2108-2116. 10.1007/s00125-008-1133-6.CrossRefPubMed Julie NL, Julie IM, Kende AI, Wilson GL: Mitochondrial dysfunction and delayed hepatotoxicity: another lesson from troglitazone. Diabetologia. 2008, 51: 2108-2116. 10.1007/s00125-008-1133-6.CrossRefPubMed
19.
go back to reference Tolman KG, Chandramouli J: Hepatotoxicity of the thiazolidinediones. Clin Liver Dis. 2003, 7: 369-379. 10.1016/S1089-3261(03)00020-5.CrossRefPubMed Tolman KG, Chandramouli J: Hepatotoxicity of the thiazolidinediones. Clin Liver Dis. 2003, 7: 369-379. 10.1016/S1089-3261(03)00020-5.CrossRefPubMed
20.
go back to reference Madden KM, Lockhart C, Cuff D, Potter TF, Meneilly GS: Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension and hypercholesterolemia. Diabetes Care. 2009, 32: 1531-1535. 10.2337/dc09-0149.CrossRefPubMedPubMedCentral Madden KM, Lockhart C, Cuff D, Potter TF, Meneilly GS: Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension and hypercholesterolemia. Diabetes Care. 2009, 32: 1531-1535. 10.2337/dc09-0149.CrossRefPubMedPubMedCentral
21.
go back to reference Vadstrup ES, Frolich A, Perrild H, Borg E, Roder M: Lifestyle trial for type 2 diabetes patients: trial protocol of the Copenhagen type 2 diabetes rehabilitation project. BMC Public Healt. 2009, 9: 166-10.1186/1471-2458-9-166.CrossRef Vadstrup ES, Frolich A, Perrild H, Borg E, Roder M: Lifestyle trial for type 2 diabetes patients: trial protocol of the Copenhagen type 2 diabetes rehabilitation project. BMC Public Healt. 2009, 9: 166-10.1186/1471-2458-9-166.CrossRef
22.
go back to reference Ukoumunne OC, Gulliford MC, Chinn S, Sterne JAC, Burney PGJ: Methods for evaluating area-wide and organisation-based trials in health and health care: a systematic review. Health Technol Assess. 1999, 3: 1-92. Ukoumunne OC, Gulliford MC, Chinn S, Sterne JAC, Burney PGJ: Methods for evaluating area-wide and organisation-based trials in health and health care: a systematic review. Health Technol Assess. 1999, 3: 1-92.
23.
go back to reference Peckham S, Hunter DJ, Hann A: The delivery and organization of public health in England: setting the research agenda. Public Health. 2008, 122: 99-104. 10.1016/j.puhe.2007.05.003.CrossRefPubMed Peckham S, Hunter DJ, Hann A: The delivery and organization of public health in England: setting the research agenda. Public Health. 2008, 122: 99-104. 10.1016/j.puhe.2007.05.003.CrossRefPubMed
24.
go back to reference American Diabetes Association: The American Diabetes Association (ADA) has been actively involved in the development and dissemination of diabetes care standards, guidelines, and related documents for many years. Introduction. Diabetes Care. 2009, 32 (Suppl 1): S1-2. American Diabetes Association: The American Diabetes Association (ADA) has been actively involved in the development and dissemination of diabetes care standards, guidelines, and related documents for many years. Introduction. Diabetes Care. 2009, 32 (Suppl 1): S1-2.
25.
go back to reference Hernandez Anguera JM, Basora Gallisà J, Ansa Echeverria X, Piñol Moreso JL, Millan Guash M, Figuerola Pino D: The Spanish version of the Diabetes Attitude Scale (DAS-3sp): an instrument for measuring diabetes - related attitudes and motivations. Endocrinol Nutr. 2002, 49: 293-298.CrossRef Hernandez Anguera JM, Basora Gallisà J, Ansa Echeverria X, Piñol Moreso JL, Millan Guash M, Figuerola Pino D: The Spanish version of the Diabetes Attitude Scale (DAS-3sp): an instrument for measuring diabetes - related attitudes and motivations. Endocrinol Nutr. 2002, 49: 293-298.CrossRef
26.
go back to reference Hernandez JM, GRETDIM: La importancia de la adaptación transcultural y la validación de la DAS-3 (Diabetes Attitude Scale) a la lengua vernácula (DAS-3cat): la versión catalana de un instrumento de medición de actitudes y motivaciones en la diabetes mellitus. Endocrinol Nutr. 2004, 51: 293-298. Hernandez JM, GRETDIM: La importancia de la adaptación transcultural y la validación de la DAS-3 (Diabetes Attitude Scale) a la lengua vernácula (DAS-3cat): la versión catalana de un instrumento de medición de actitudes y motivaciones en la diabetes mellitus. Endocrinol Nutr. 2004, 51: 293-298.
Metadata
Title
Safety during the monitoring of diabetic patients: trial teaching course on health professionals and diabetics - SEGUDIAB study
Authors
Juan J Cabré
Marta Ripoll
Josep M Hernández
Josep Basora
Ferran Bejarano
Victoria Arija
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-430

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue